Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From Jan.61 to Dec.81, 117 patients with seminoma of testis were treated in the Leon Berard Centre, Lyon. All had undergone lymphography during investigation of possible extension, 19 were treated with 200 KV up 1966, 64 with Cobalt up to 1978 and 29 with photons x of 18 MV since that date. From 1979 adjuvant chemotherapy has always included cisplatinum. The 5 years survival rate was 95% of stage I (51/54 cases), 72% of stage II (26/36 cases) and 1/7 of stage III. Unsuccessful treatment of neoplasm was noted in 23 patients, in 80% of cases during the first two years and involving mainly pulmonary metastases. Three patients had mediastinal metastases while recovery surgery was possible in 4 cases. Three fatal iatrogenic complications were observed. Since the use of high energies, particularLy x beams of 18 MV there has been almost total absence of radic complications. Therapy now proposed is as follows: stage I: surgery plus radiotherapy; stage II A-B: surgery and irradiation avoiding mediastinum; stage II C and III: primary chemotherapy.
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PMID:[Seminoma of testis. Analysis of failures and development of therapeutic strategies. Apropos of a Lyons series of 117 cases]. 380 47

Seven patients with large cervical node metastases were treated at the Institut Jean-Godinot using a particular scheme of accelerated irradiation. Conventional Cobalt-60 radiotherapy was prophylactically delivered to extended volumes of the neck (50 Gy in 25 fractions over 5 weeks). Within the fields of cobalt irradiation, an electron beam field was added to increase the daily dose from 2 to 3 Gy (Fletcher's field in the field technique). The increment of dose was limited to nodal area. Since no interval separated the two irradiations, involved areas were considered to receive 70 Gy in 25 fractions over 5 weeks and non-clinically involved areas to receive 50 Gy in 25 fractions over 5 weeks. In all the cases, the malignant mass diameter exceeded 5 cm. Acute tolerance was good and no major late injury was observed during the 18 months minimum follow-up period. At the end of the treatment, a complete disappearance of the tumor was observed in six out of seven cases. At the present time, four patients are still alive without evidence of disease. Slight acceleration of irradiation by the use of a concomitant electron boost is easily feasible and may provide an improvement in local control and therapeutic ratio of large cervical malignant masses in the neck.
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PMID:The use of a concomitant electron boost (field in the field technique) in large cervical node metastases over a shortened period. 644 Nov 95

A 68-year-old man with old-standing Paget's disease of bone developed in 1975 an isolated sarcoma of the left elbow confirmed by biopsy. The sarcoma responded to irradiation and multiple chemotherapy. In August 1979, pain started along the right sciatic nerve. Clinical examination revealed a tumour deep in the right gluteal region, which was found to be another sarcoma close to the sacro-iliac joint, Cobalt irradiation produced little symptomatic improvement, and the patient died four months later, presumably of metastases. Since January 1979 the Paget's disease had been treated with dichloromethylene diphosphate with satisfactory clinical, biochemical and histological results, but the drug did not influence the course of the sarcoma.
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PMID:[Multifocal sarcoma associated with Paget's disease of bone. Effects of dichloromethylene diphosphate (author's transl)]. 645 48

A method has been devised for evaluating the rate and extent of regression of the first 100 consecutive patients with a posterior uveal melanoma that we had managed by Cobalt-60 plaque radiotherapy at Wills Eye Hospital. It was found that the "average" posterior uveal melanoma in the series did not regress rapidly to a flat, depigmented scar but shrank slowly and persisted as a residual mass approximately 50% of the thickness of the original tumor at 54 months following Cobalt-60 plaque radiotherapy. We also found that the rate and extent of regression of the tumors in patients who subsequently developed metastatic melanoma were not appreciably different than the rate and extent of regression of the tumors in patients who remained well systemically. These observations indicate that the rate and extent of regression of posterior uveal melanomas following Cobalt-60 plaque radiotherapy are poor indicators of the prognosis of the affected patients for subsequent development of clinical metastatic disease.
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PMID:Regression of posterior uveal melanomas following cobalt-60 plaque radiotherapy. 652 1

Given that metastatic hepatic malignancy remains as a significant cause of death, with a median survival after diagnosis of only 7 months despite treatment, there exists a need for some effective treatment modality. Internal radiotherapy in the form of yttrium-90 microspheres infused into the hepatic artery appears to be a promising method of therapy. One criterion required for the success of this treatment is that of a differentially greater arterial supply to tumor as opposed to liver tissue. This arterial hypervascularity of tumor has been demonstrated before. However, some conflict has been reported as to the maintenance of this state as tumor size increases. Using 15 micrometers Cobalt-57 microspheres for studying salivary adenocarcinoma implants in DA rat livers, these experiments have demonstrated a constant blood flow in the tumor periphery of 3.9 times that within the normal hepatic parenchyma, regardless of tumor size. Also demonstrated is a progressive decrease in central tumor arterial blood flow after a tumor diameter of 6 mm has been exceeded. Arterial hypervascularity of liver tissue adjacent to the tumor has been demonstrated while an intermediate zone of liver tissue appeared hypovascular, suggesting the presence of shunting. In three humans with metastatic liver disease, hepatic artery infusion of particulate radiotracer has demonstrated the peripheral tumor hypervascularity and relative central tumor hypovascularity with good correlation obtained with the images of the metastases on conventional colloidal hepatic scintigraphy. This method allows assessment of the patient's suitability for internal radiotherapy by enabling assessment of the tumor vascularity and the degree of potentially dangerous extrahepatic irradiation.
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PMID:Internal radiotherapy for hepatic metastases II: The blood supply to hepatic metastases. 668 44

The role of the radiation therapist in the management of malignant intraocular tumors is changing. With more active identification of malignant intraocular tumors, and a better recognization of the manner in which one can deal with problems of radiation sensitivity, radiation techniques of all sorts will be more actively employed in the treatment of these tumors. Special techniques must be selected for appropriate circumstances of management in order to diminish to an absolute minimum the impact upon the lens, the impact upon visual acuity and the impact upon the cornea. Cobalt-60 plaques are being used more commonly in the treatment of melanomas of the choroid, and the role for radiation therapy in the management of retinoblastoma is changing markably to where it may be used as the primary treatment program rather than enucleation. In metastatic disease involving the uveal tract, radiation therapy has assumed the most important role for management. Chemotherapy should be considered as an active adjuvant in the management of not only those individuals with retinoblastoma but also in those identified circumstances where metastases to the uveal tract are being treated. The role for chemotherapy or immunotherapy in malignant melanoma is unclear.
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PMID:Malignant intraocular tumors. 680 Jun 27

From 1960 through 1976, 353 consecutive patients with carcinoma of the tonsillar region were primarily treated with radiation therapy. The mean age of patients was 58 years with males predominating (78%). Patients were classified according to a TNM and stage classification. Most of the tumors were large, and the specific site of origin could not be determined in 33% of the patients. The predominant identifiable sites were the soft palate and uvula, 18%, the anterior tonsillar pillar, 18%, and the tonsillar fossa, 13%. Patients were treated with radiation to doses of 6700 rad given in 48 days and 33 fractions using Cobalt 60 radiation. We found a 91.7% control rate for patients with T1 disease and 76.9%, 49.5%, and 25% for T2, T3, and T4 patients, respectively. The overall local control rate was 62.3%. Surgery was used most often in recurrences for Stage III patients. Salvage surgery was carried out in 93 patients. Surgery was more successful in controlling the disease in patients in whom the primary was controlled by irradiation. Overall, the tumors in 43% of the patients who had surgery were subsequently controlled as a result of this treatment. Metastasis occurred rapidly, with 75 of the patients exhibiting metastases by 18 months. Complications were not related to dose but were slightly higher in patients who had surgery (5%). We conclude that radiation therapy is the preferred treatment for Stage I and II squamous cell carcinoma of the tonsillar region. No satisfactory results were obtained in Stage IV; other approaches should be tried.
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PMID:Radiation therapy of carcinoma of the tonsillar region. 683 15

From July 1970 to January 1977, 23 patients with previously untreated cancer of the cervix (CA CX), mostly Stage IIIB, were included in this study. The para-aortic lymph nodes (PALN) were histologically documented to have metastatic disease in all 23 patients. External radiation treatment (RT) was delivered using a Cobalt--60 machine to a spade-shaped field to treat the pelvic cavity and para-aortic area. The majority of the patients received 4000-6000 rad to the pelvic cavity and from 5000-5500 rad to the PALN's by external RT. In addition, intracavitary radium was used in 21 patients. Five patients are alive and free of disease at 115, 110, 90, 73 and 45 months after completion of RT. One survivor had clinical Stage IB, one had Stage IIB, and three had Stage IIIB cervical carcinoma. Two of 15 patients with clinically enlarged and suspicious para-aortic nodes are alive, while 3 of 8 patients with clinically normal appearing nodes survived. Three (60%) of the survivors developed late bowel radiation damage. Eighteen patients died--10 during the first year, 3 during the second year, 2 during the third year, 1 during the fourth year and 2 during the eighth year of the follow-up. Five (27.8%) of the patients who died had developed late bowel radiation damage. Fifteen of the 18 died with disease at an average of 21 months. Three patients died of intercurrent disease. Their average survival was 40 months, double that of patients dying of disease. This report suggests that in cancer of the cervix, radiation therapy can control some PALN metastatic disease, but the risk of complications is rather high. In the absence of better methods of management, this risk of complications is justifiable because the alternative is to leave known disease untreated.
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PMID:Para-aortic lymph node irradiation in carcinoma of the cervix after exploratory laparotomy and biopsy-proven positive aortic nodes. 706 Dec 47

A follow-up study of 69 patients with malignant tumors of the hypopharynx is reported. They were treated either with Cobalt-60-gamma-rays or with 19 MeV Betatron X-rays mainly up to a dose of 60 Gy over a 6 week period. 53 of the 67 patients with carcinomas had very large tumors (T3 and/or N3). The 3-year survival rate in group N0 was 15%, and in group N1--3 7%. These rates could not be improved on by radical operations prior to radiotherapy. 51 of the 67 patients with carcinomas died due to local or regional disease. 7 patients developed distant metastases. These results could not be improved on by increasing the dose to 70,0 Gy.
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PMID:[Radiation therapy of tumors of the hypopharynx (author's transl)]. 723 Oct 18

This study documents dosage to radiation sensitive organs/structures located outside the radiotherapeutic target volume for four treatment situations: (a) head and neck, (b) brain (pituitary and temporal lobe), (c) breast and (d) pelvis. Clinically relevant treatment fields were simulated on a tissue-equivalent anthropomorphic phantom and subsequently irradiated with Cobalt-60 gamma rays, 6- and 18-MV x-ray beams. Thermoluminescent dosimeters and diodes were used to measure absorbed dose. The head and neck treatment resulted in significant doses of radiation to the lens and thyroid gland. The total treatment lens dose (300-400 cGy) could be cataractogenic while measured thyroid doses (1000-8000 cGy) have the potential of causing chemical hypothyroidism, thyroid neoplasms, Graves' disease and hyperparathyroidism. Total treatment retinal (400-700cGy) and pituitary (460-1000 cGy) doses are below that considered capable of producing chronic disease. The pituitary treatment studied consisted of various size parallel opposed lateral and vertex fields (4 x 4 through 8 x 8 cm). The lens dose (40-200 cGy) with all field sizes is below those of clinical concern. Parotid doses (130-1200 cGy) and thyroid doses (350-600 cGy) are in a range where temporary xerostomia (parotid) and thyroid neoplasia development are a reasonable possibility. The retinal dose (4000 cGy) from the largest field size (8 x 8 cm2) is in the range where retinopathy has been reported. The left temporal lobe treatment also used parallel opposed lateral and vertex fields (7 x 7 and 10 x 10 cm). Doses to the pituitary gland (5200-6200 cGy), both parotids (200-6900 cGy), left lens (200-300 cGy) and left retina (1700-4500 cGy) are capable of causing significant future clinical problems. Right-sided structures received insignificant doses. Secondary malignancies could result from measured total treatment thyroid doses (670-980 cGy). Analysis of three breast/chest wall and regional nodal irradiation techniques demonstrated a 25-50% decrease in secondary lung dose with use of independent collimation compared to use of custom alloy blocking material. However, it is unlikely that a reduction in secondary dose of this magnitude would reduce the risk of treatment sequellae. In four-field "box" pelvic irradiation, secondary testes dose may result in temporary (clamshell shield) or permanent azoospermia, but is unlikely to impair androgen production.
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PMID:Doses to radiation sensitive organs and structures located outside the radiotherapeutic target volume for four treatment situations. 840 17


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